The latest Journal of the American Medical Association reports on a study comparing the health of a representative sample of white American and English 55-64 year olds. The conclusions are stark.
The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer.
The study also looked at the health of different socio-economic groups within the countries. Not surprisingly, there was a great difference between the richest Americans who could afford unlimited health care and the poorest. A similar, though less pronounced, effect was found in Britain. BUT the richest Americans have levels of disease comparable to those in England with the poorest health.
[UPDATE I have slightly changed the piece above the fold to make it clear that the UK data sets are for England only.]
The BBC site has a more digestible report on the study with an interview of a co-authors from University College London (UCL) and the Rand Corporation of the USA.
Those on the lowest incomes in both countries reported most cases of all diseases, except for cancer, and those on the highest incomes the least.
But these health inequalities were more pronounced in the US than they were in England.
The researchers suggested the lack of social programmes in the US, which in the UK help protect those who are sick from loss of income and poverty, could partly help explain why there was a greater link between Americans’ wealth and disease.
But the study also found that differences in disease rates between the two nations were not fully explained by lifestyle factors either.
Even when you discount things like smoking (similar in both countries), alcohol (higher in the UK) and the greater tendency to obesity in the USA, the differences persist. Professor Sir Michael Marmot, of the department of epidemiology and public health at University College London and one of the researchers is quoted as saying:
We cannot blame either bad lifestyle or inadequate medical care as the main culprits in these socio-economic differences in health.
We should look for explanation to the circumstances in which people live and work.
We have to take a much broader look at social determinants of health in both countries.
We need to do further research to fill in the jigsaw pieces of the puzzle,
The one thought that comes to mind is the differences in working patterns. American friends are always shocked to hear just how much holiday time the British have – in this age group five weeks plus public holidays would be typical. Add in that far more commuting is done by public transport (less stressful than driving in heavy traffic). Could the difference be that the English work to live but the Americans die to work?
